NPI | 1558346858 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 20828) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY TP155) |
2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35086553) | |
Enumeration Date | 2005-12-08 |
Last Update Date | 2010-01-08 |